目的 探討阿奇霉素和頭孢他啶對難治性肺炎支原體肺炎患兒的臨床療效及血清乳酸脫氫酶（LDH）的變化影響。方法 2014年1月—2017年1月選擇在鄭州市婦幼保健院診治的120例難治性肺炎支原體肺炎患兒作為研究對象，根據(jù)隨機信封抽簽原則分為觀察組與對照組各60例，觀察組在常規(guī)治療基礎上給予阿奇霉素輔助治療，0.25 g/次，1次/d，對照組在常規(guī)治療基礎上給予頭孢他啶輔助治療，10～50 mg/kg加入0.5%氯化鈉注射液50～100 mL內，靜脈泵入，2次/d。兩組都治療14 d。結果 觀察組與對照組患兒總有效率分別為98.3%和86.7%，觀察組患兒的總有效率顯著高于對照組，差異有統(tǒng)計學意義（P<0.05）。觀察組與對照組患兒治療后的血清LDH水平分別為（143.22±26.29）U/L和（245.10±30.91）U/L，都明顯低于治療前的（445.20±35.10）U/L和（438.10±56.11）U/L（P<0.05）；且治療后觀察組患兒的血清LDH水平也明顯低于對照組，差異有統(tǒng)計學意義（P<0.05）。觀察組患兒治療期間的皮疹、胃腸道反應、疼痛、發(fā)熱等不良反應發(fā)生率為11.7%，對照組為10.0%，兩組對比無明顯差異。結論 相對于頭孢他啶，阿奇霉素治療難治性肺炎支原體肺炎患兒能提高治療效果，且不會增加不良反應，其作用機制可能與促進血清LDH含量降低有關。

Objective To investigate the effect of azithromycin and ceftazidime on serum lactate dehydrogenase (LDH) in children with refractory mycoplasma pneumoniae pneumonia.Methods From January 2014 to January 2017, 120 children with refractory mycoplasma pneumoniae pneumonia in Women and Infants Hospital of Zhengzhou were selected as research object, all the cases were equally divided into observation group and control group with 60 cases in each group according to the random draw envelope principle, the observation group was given azithromycin adjuvant treatment, the control group was given cephalosporin adjuvant therapy, two groups were treated for 14 d.Results The total effective rates of observation group and control group were 98.3% and 86.7%, respectively, the total effective rate of observation group was significantly higher than that of control group, the difference was statistically significant (P<0.05). The serum levels of LDH in observation group and control group after treatment were (143.22±26.29) and (245.10 ±30.91) U/L that were significantly lower than those before treatment of (445.20 ±35.10) and (438.10 ±56.11) U/L (P<0.05), and the serum level of LDH in observation group after treatment was significantly lower than that of the control group (P<0.05). The incidence of adverse reactions such as rash, gastrointestinal reaction, pain, fever and other adverse reactions in the observation group was 11.7%, which was 10.0% in the control group. Comparison between the two groups had not significant difference (P<0.05).Conclusion Compared with cephalosporins, azithromycin in the treatment of refractory mycoplasma pneumoniae pneumonia in children can improve the therapeutic effect, and does not increase the incidence of adverse reactions, the mechanism may be related to the decrease of the content of serum LDH.